The burden of infection in long-term care

Area of Science:

• Healthcare epidemiology
• Infectious disease prevention
• Long-term care facility management

Background:

• Infections represent a significant, underestimated health burden in US long-term-care facilities (LTCFs).
• Existing data suggest endemic infection rates rival or exceed those in acute-care settings.
• Outbreaks of various pathogens further exacerbate the infection burden in LTCFs.

Purpose of the Study:

• To quantify the substantial burden of infections in US long-term-care facilities.
• To underscore the economic and clinical impact of infections in this vulnerable population.
• To inform research priorities for infection control in LTCFs.

Main Methods:

• Analysis of available fragmentary data on infection frequencies in LTCFs.
• Estimation of annual endemic infection rates.
• Assessment of infection impact through antimicrobial use, hospital transfers, and mortality data.

Main Results:

• Estimated endemic infections range from 1.64 to 3.83 million annually in US LTCFs.
• Infection-related costs in LTCFs exceed $1 billion per year.
• Infections are demonstrably non-trivial, evidenced by antimicrobial use, hospital transfers, and mortality.

Conclusions:

• Infections pose a major challenge to long-term-care facilities in the United States.
• The economic and clinical impact of infections in LTCFs necessitates focused research and intervention.
• Understanding the infection burden is crucial for developing effective strategies in this growing healthcare sector.